Misunderstanding of Miscarriage Common, Study Finds

Ricki Lewis, PhD

May 08, 2015

Misconceptions about the causes of miscarriage are widespread, with more than half of survey respondents saying that miscarriage is rare, according to results of a survey published online May 6 in Obstetrics & Gynecology. Moreover, survey responses show that many people feel guilty after suffering a miscarriage, and most are unaware of its causes.

To investigate knowledge gaps among patients and their partners about miscarriage, Jonah Bardos, MD, from the Albert Einstein College of Medicine of Yeshiva University and Montefiore Medical Center, New York City, and colleagues administered a national, cross-sectional survey of 33 questions to men and women aged 18 to 69 years.

Respondents answered the survey, which was available online. Of 1084 participants, 55% were women and 45% were men.

Fifteen percent of respondents had suffered more than one miscarriage. The survey defined miscarriage as pregnancy loss before the 20th week.

Most (55%) respondents believed that miscarriages are uncommon, occurring in less than 6% of all pregnancies, and 10% thought the incidence was below 2%. Men were more likely to have this misperception than women (odds ratio of men to women, 2.5; confidence interval, 1.87 - 3.15).

About three quarters (74%) of participants knew that miscarriage is usually a result of a genetic or health problem, and those with a college education were more likely to be aware of this fact. However, 22% believed that alcohol consumption, drug use, or tobacco use during pregnancy are the most common causes of miscarriage.

Abnormal chromosomes cause about 60% of the nearly 1 million miscarriages in the United States each year. Although 95% of respondents reported knowing that genetic problems could cause miscarriage, respondents also attributed miscarriage to stress (76%), lifting heavy objects (64%), a past sexually transmitted infection (41%), past use of an intrauterine device (28%) or oral contraception (22%), or arguing (21%).

The survey probed emotional responses to pregnancy loss, and found that 47% of respondents felt guilty, 41% felt they had done something wrong, 41% felt alone, 36% felt they had lost a child, and 28% felt shame. Religious affiliation was associated with more than double the likelihood of perceiving the loss as equivalent to that of losing a child. Respondents reported feeling comforted when friends or public figures openly discuss miscarriage.

Learning a medical explanation for the miscarriage helped alleviate guilt. Most respondents (78%) expressed a wish to learn the cause, even if the loss was inevitable. More than a third (38%) of respondents with a history of miscarriage thought they could have prevented the loss, and 57% of them said they had not been given a reason for the loss. Those given a reason were 19% less likely to report feeling guilt.

"Our data could encourage friends and public figures to share their losses and use their stature to help combat feelings of shame, secrecy, and isolation," the investigators write. They also call for healthcare providers to provide "emotional and educational support" to more patients experiencing pregnancy loss.

A limitation of the study is that its voluntary design resulted in underrepresentation of Hispanics and blacks and overrepresentation of Asians and individuals with strong feelings about miscarriage.

The researchers have disclosed no relevant financial relationships.

Obstet Gynecol. Published online May 6, 2015. Abstract


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